Infertility

Introduction: Infertility in Africa?

Having children is seen as a blessing in many African societies, and for many couples, it is a great source of joy. However, millions of African couples face the heartbreaking struggle of infertility. According to the world health organization (WHO), about 10–15% of couples in Africa experience infertility. In some communities, women facing infertility are stigmatized, even though men contribute to infertility just as often as women. It is important to understand infertility, its causes, and available solutions so that affected couples can seek help and make informed choices.

What is infertility?

Infertility means a couple is unable to have a baby after trying for at least one year (having regular unprotected sex at least three times a week). For women aged 35 and above, infertility is considered after six months of trying. Infertility also includes cases where a woman gets pregnant but is unable to carry the pregnancy to term.

There are two types of infertility:

• Primary infertility: When a woman has never been able to conceive.
• Secondary infertility: When a woman has been pregnant before but is unable to conceive again.

Common misconceptions about infertility?

Many people believe infertility is only a woman’s problem, but this is false. Infertility affects both men and women equally. Some also think that a man who has had children before cannot be infertile, but factors like age, lifestyle, and medical conditions can cause infertility at any stage in life.

How common is infertility in Africa?

Infertility rates vary across Africa, with some regions experiencing higher rates due to infections, untreated sexually transmitted diseases (STDs), and unsafe abortions. Studies show that up to 30% of couples in some African countries struggle with infertility. This has led to social pressures, emotional distress, and in some cases, marital conflicts.

Causes of infertility in men?

Male infertility is usually due to problems with sperm. The sperm may be too few, abnormal in shape, or unable to move properly. Some key causes include:

• Low sperm production
• Blockages preventing sperm movement
• Poor sperm shape and quality

Risk factors for male infertility?

Certain habits and conditions can increase a man’s chances of infertility, such as:

• Older age
• Smoking and alcohol consumption
• Being overweight or obese
• Exposure to harmful chemicals (pesticides, heavy metals, and herbicides)
• Wearing very tight underwear that heats up the testicles
• Frequent use of certain medications, such as steroids and antidepressants

Medical conditions that affect male fertility?

• Varicocele (swollen veins in the testicles)
• Hormonal imbalance, leading to low sperm production
• Untreated infections (e.g., sexually transmitted infections like chlamydia or gonorrhea)

Causes of infertility in women

Female infertility is often caused by issues that affect the ovaries, fallopian tubes, or uterus. For pregnancy to occur, a woman must release an egg (ovulation), the egg must be fertilized by sperm, and then the fertilized egg must implant in the uterus. If anything disrupts this process, it can lead to infertility.

Risk factors for female infertility?

• Age (fertility decreases after 30 years)
• Smoking and alcohol consumption
• Being overweight, obese, or underweight
• Untreated sexually transmitted infections (STIs)

Medical conditions that affect female fertility?

• Polycystic ovary syndrome (PCOS): A hormonal imbalance that prevents ovulation
• Blocked fallopian tubes: Often caused by infections or previous surgeries
• Endometriosis: A condition where tissue similar to the lining of the uterus grows outside the uterus
• Uterine fibroids: Non-cancerous growths in the uterus that may prevent pregnancy How is infertility diagnosed?

Tests for men

Men experiencing infertility should see a doctor if they notice:

• Difficulty with erection or ejaculation
• Low sex drive
• Swelling or pain in the testicles
• History of surgery in the genital area

The doctor may conduct a semen analysis to check sperm count, shape, and movement.

Additional tests such as hormone tests, ultrasound, or genetic tests may also be needed.

Tests for women

Women under 35 should see a doctor if they have not conceived after one year of trying, while those over 35 should seek help after six months. The doctor will check:

• Menstrual cycle patterns
• Pelvic conditions (e.g., fibroids, infections, or endometriosis)
• Ovulation through hormone tests
• Fallopian tubes through an X-ray test (hysterosalpingography, HSG)

Treatment options for infertility?

Infertility can be treated depending on the cause and the couple’s preferences. Available treatments include medications, surgery, and assisted reproductive technologies (ART) such as in vitro fertilization (IVF).

Treatment for men

• Surgery: To remove blockages or repair swollen veins in the testicles
• Medication: To balance hormones and improve sperm production
• Assisted reproductive technology (ART): Sperm is collected and used for artificial fertilization

Treatment for women